Wednesday, July 6, 2011

Should Anointing of the Sick be given before surgery?

Is any man sick among you?
Let him bring in the priests of the church, and let them pray over him,
anointing him with oil in the name of the Lord. And the prayer of faith shall
save the sick man. (James
5:14-15)

“The Sacrament of the Anointing of the Sick is
given to those who are seriously ill.” (Paul VI, Apostolic Constitution Sacram Unctione Infirmorum, 30 Nov 1972)

“It
is fitting to receive the Anointing of the Sick just prior to a serious
operation.” (CCC 1515)

Happily,
the sacrament of Extreme Unction is no longer (in the popular thought of the faithful)
relegated solely to the last moments of life, but is celebrated much more conveniently
when the sickness first begins to seriously threaten life. Most unhappily, a
widespread confusion has occurred as to the whether (and, as the case may have
it, why) the sacrament of Anointing is to be given before serious surgery.

Many
of the Christian faithful (indeed, even many of the priests) are of
the mistaken opinion that serious life-threatening surgery is, in itself, a
cause for the administration of the sacrament of Anointing. This confusion
could be perpetuated by the brief words of the Catechism of the Catholic Church
(as reproduced above), but can be easily corrected if we consider the nature of
the sacrament.

As
we shall see, serious (and even life-threatening) surgery is not a cause for
the reception of Anointing of the Sick. Likewise, other foreseen life-threatening
events (such as deployment for military service or capital punishment) do not
render a person fit to be a recipient of this sacrament.

What is this sacrament?

The
sacrament of Anointing of the Sick confers a spiritual healing through the
sacramental sign of a physical healing – even though it is not always the case
that a physical healing actually occurs. Sacraments effect what they signify,
such that the very nature of the sacramental order is that signification is
essential to the working of the sacramental effect.

In
the case of Extreme Unction, oil is used to signify physical healing. We must
recall that, in ancient times (and still today), oil is used unto medicinal
effect. The anointing of oil is meant to produce physical health. This physical
healing itself signifies the spiritual healing.

As
baptism washes the soul through the sacramental sign of a bodily washing, and
the Eucharist feeds the soul through the sacramental sign of a bodily feeding
(and so forth for all the sacraments), so too, Anointing heals the soul through
the sacramental sign of bodily healing. Neither does it matter that the waters
of baptism may not literally wash the body, nor that the Sacred Host provide little
physical nourishment, nor that the anointing of oil not effectively produce
physical healing – the sacramental sign is enough (even without the accomplishment
of a substantial physical effect) to signify and effect the spiritual reality.

Who is to receive this
sacrament?

The
Church is quite clear: Only those who suffer from a grave illness which puts
the individual in a real danger of death are to receive the sacrament of Anointing
of the Sick. There is a reason why it is not called merely “Anointing”, but
rather “Anointing of the Sick” – it is for sick persons, indeed for those whose
sickness is unto death.

St.
James makes this clear as he writes: Is
any man sick among you? Further, Pope Paul VI re-iterates this point in his
Apostolic Constitution: “The Sacrament of the Anointing of the Sick is given to
those who are seriously ill.” Even the Catechism states: “The Church believes
and confesses that among the seven sacraments there is one especially intended
to strengthen those who are being tried by illness, the Anointing of the Sick.”
(CCC 1511)

As
the sacrament effects spiritual healing through the sign of physical healing,
only those who are physically ill (i.e. whose health is gravely impaired
through some serious illness) are capable of receiving this sacrament.

St.
Thomas conveys this point with great clarity: “This sacrament is a spiritual healing,
as stated above (q.30, aa.1,2), and is signified by way of a healing of the
body. Hence this sacrament should not be conferred on those who are not
subjects for bodily healing, those namely, who are in good health.” And again, “Although
spiritual health is the principle effect of this sacrament, yet this same
spiritual healing needs to be signified by a healing of the body, although
bodily health may not actually ensue. Consequently spiritual health can be
conferred by this sacrament on those alone who are competent to receive bodily
healing, viz. the sick.” (ST Supplement, q.32, a.1, co.; q.32, a.1, ad 1)

The
sacrament is very clearly intended not merely for any who are in danger of
death from any cause – whether from surgery or from military deployment or from execution –
but only for those who are in danger of death due to an illness (and this
includes also those whose health is seriously impaired due to old age). The
sacrament is not of the “dying” in generally, but of the “sick” (meaning, of
those who are seriously ill).

Still,
the Church advises both priests and faithful to avoid scrupulosity in this
matter: “A prudent or reasonably sure judgment, without scruple, is sufficient
for deciding on the seriousness of an illness; if necessary a doctor may be
consulted” (General Introduction to the Rite of Anointing of the Sick, 8). Hence,
two extremes must be avoided: On the one hand we must not delay Anointing, on
the other hand we must not administer the sacrament when there is no illness which
gravely impairs the health of the individual. Until the person is seriously
ill, they are not to receive the sacrament of Anointing.

In
other words, if a sickness is present and there is reasonable evidence to
conclude that this illness is serious (i.e. could result in death and already
significantly impairs health), then Anointing of the Sick should be
administered. However, if there is no serious sickness, then the sacrament
should not be given. Hence, it is not to be given on account of serious surgery
nor before war nor before execution – for none of these events constitute a
serious illness. It is not enough simply to be in danger of death – one must be
sick (including extreme old age which seriously impairs health) in order to
receive the sacrament of the sick.

[it must be noted that certain severe forms of mental illness, which seriously impair health as to potentially lead to death, are also cause for the administration of Anointing]

Why Anointing is not to be
given for surgery, but may be given before surgery

If
it is clear that serious and even life-threatening surgery is not a cause for
Anointing, why does the Catechism of the Catholic Church state: “It is fitting
to receive the Anointing of the Sick just prior to a serious operation” (CCC
1515)? We can find our answer by looking more closely at the Introduction to
the Rite (which is provided by the Church and approved by the Holy Father).

The
Introduction to the Rite of Anointing of the Sick states (paragraph 9): “A sick
person may be anointed before surgery whenever a serious illness is the reason
for the surgery.” Thus, it is fitting, when a serious illness is present and
when this illness has necessitated a serious surgery, to receive this sacrament
before undergoing surgery. The seriousness of the surgery is not itself the
cause of the administration of the sacrament, but rather provides an occasion in
which it becomes more necessary that the sacrament be received.

While
Anointing of the Sick is always given for the spiritual healing of those who
are seriously ill, it is especially necessary when there is grave danger of
death. If a person suffering from a serious illness must undergo a dangerous
surgery, it will be all the more necessary for him to receive Anointing – the cause
of Anointing is the serious (and life-threatening) sickness, but the occasion
is brought about by the danger of death which accrues to the surgery.

In
this matter, there is grave need for reform (at least in the United States) –
indeed, all too often the sacrament is given before surgery when there is no
serious illness present, resulting in the exposing of the sacrament to nullity,
which is a serious matter indeed.

51
comments:

Larry
said...

Dear Fr. I am glad you are not my pastor. Nullity of the Sacrament! Holy smoke. Considering today that even a tooth extraction procedure can result in death I find it hard to believe that you vote for limiting the administration to those who are dying. Serious is not critical and I think Paul VI undeerstood the difference. Notice that in the letter of James is not "is some at death's door" but is anyone "sick" among you. No we should not see this administered to people who are not truly sick. But if one is having surgery it is fairly serious and they do ask you to sign a document that tells you you could die from the procedure alone. That is my book is danger of death. And soldiers going into a battle...Are you telling God "No healing needed here God cause I know better".

Larry,Two things ... first, I doubt that you have actually read the article ... you certainly didn't read it carefully ... I never claimed that Anointing was only for those "at death's door" ... I only quoted the Instruction approved by Pope Paul VI.

second, you seriously misunderstand the nature of the sacrament of the sick ... it's not the sacrament of the dying, therefore it should not be given to those who are in danger of death but not seriously ill (i.e. soldiers).[as you can see, your own logic turns back on itself ... first you say that the sacrament doesn't need to be connected with death; then you say that because surgery could cause death, the sacrament should be given!]

In any case, you are voicing your own personal opinion ... which is quite dangerous, since the sacraments are to be administered according to the mind of the Church.

My article is based on what the Church actually teaches ... and on what Pope Paul VI actually said ... Anointing can be given before surgery, only if a dangerous (i.e. serious) illness is the cause of the surgery.

To expose the sacrament to nullity is grave matter ... it could be a mortal sin if done with knowledge and consent ... I'm surprised you are so cavalier about it.

[regarding my worthiness to be a pastor of souls ... please avoid such slanderous remarks in the future]

From the Code of Canon Law:"Can. 1004 §1 The anointing of the sick can be administered to any member of the faithful who, having reached the use of reason, begins to be in danger of death by reason of illness or old age."

Notice, "danger of death by reason of ILLNESS or OLD AGE" ... not simply danger of death (as from surgery or war), nor simply illness (as a common cold) ... but danger of death by virtue of a serious illness or advanced age.

The mind of the Church is clear on this matter ... and many priests have led the flock astray over recent years.

There is something that bothers me about the particular argument about surgery. As a general rule of thumb, surgery that has a serious risk of causing death will only be performed when the patient is sick enough that there is a serious risk of the patient dying without the surgery (though perhaps at a more distant point down the road). So applying that reasoning, I hope that someone going in to receive bypass surgery can receive the sacrament.

I guess the question is, what about serious, life threatening injury. In other words, if I were hit a car and had serious internal bleeding, would I be able to receive the sacrament?

Great article. I've been trying to get our parish to get rid of the annual free-for-all anointing to no avail.

I would like to share a little anecdote regarding both avoiding extremes and the hand of our Blessed Mother. My father had always worn his scapular and attended Mother of Perpetual Help devotions at a different parish (until that priest) retired. He had been experiencing an upset stomach for about a week and on Sunday decided to stay home from Mass (VERY unusual). So, due to his age (73) we decided to take him to the ER. They couldn't do anything and checked him in. When he got to the room, the SAME retired priest who did the MPH was coming around and stopped in to say hi. He then asked if Dad wanted anointing. Normally, an upset stomach would not have warranted it, but given everything, he accepted. Turns out, the problem was not in the stomach, but an aggressive from of brain cancer, which got him within 10 weeks of diagnosis. Mary had made sure Dad got his Last Sacraments.

In the event of a person facing surgery who is not currently suffering an illness...a hernia operation, say, or the dental surgery referred to above...it would seem the proper Sacrament to seek prior to undergoing the operation is Penance rather than Anointing of the Sick.

MarylandBill,The truth is that most of the surgeries that people consider "serious" enough for Anointing are not considered serious by the doctors ... for example, the use of anesthesia is not considered "life-threatening" by doctors (at least it is not "serious"), but many people are under the mistaken notion that anesthesia alone (regardless the lack of any serious illness) warrants Anointing.

Regarding an injury ... if it is serious (i.e. puts the person "in danger of death" [Can 1004]), then the injury can certainly qualify as an illness that warrants Anointing.

First, forgive me if this is a repeat, not sure I entered my first effort properly. My difficulty is seeing a distinction between serious surgery and serious illness. They seem to go together. Can you share a few examples where serious surgery is not simultaneous with serious illness? Thanks for the informative blog.

Jesus healed the sick. He didn't check to see if it was serious or not. In the early days of the Church this was also true. To withhold the sacrament depending on the severity of the patient's condition is in my view in error.

Beth,Are you suggesting that Anointing of the Sick is identical to Jesus miraculous healings?In any case, you are opposing the Christ and the Church ... as though the Church has abandoned the teaching of Christ ...... what is quite clear to me is that you have little understanding of what actually occurred "in the early days of the Church" ... since the history of the sacrament of Anointing is quite complicated.

We have to think with the Church ... we simply have to stop forcing our own opinions and look instead to the actual teaching of the Church ...

[in other words ... I don't care what "in your view" is an error ... I want to know what is an error according to the teaching of the Church.]

Ray from MN,Generally, we say that a condition is "serious" if it puts the patient in a real danger of death and significantly impairs his health.

So, it would be good to consult with a doctor and ask if your high blood pressure puts you in a real danger of death.Also, it is good to consider whether the blood pressure impairs your health -- does it keep you from fulfilling the normal actions of human life?

Also, we are told that -- when there is a real doubt as to whether or not an illness puts one in danger of death (whether it is serious) -- we ought to consult a doctor (and, of course, the parish priest) and err on the side of administering the sacrament.

{if there is no real doubt, i.e. if the illness is clearly not life-threatening or serious (or if there is no real illness at all, but only a surgery [e.g. removal of tonsils]), then we must not make us of the sacrament}

Michael G.,Regarding "serious surgery" ... Unfortunately, many people speak of any surgery which uses anesthesia as "serious surgery" ... hence, people will receive Anointing of the Sick (in fact the sacrament is null) for surgeries like removal of tonsils, repair of a torn ACL, removal of wisdom teeth, etc.

This is the practice which I am criticizing in the article. It is contrary to the mind of the Church and the nature of the sacrament.

Dear Reginaldus,As a matter of fact I do have an understanding of healing in the early days of the Church, and it was quite commonplace. As support for my opinion, I refer you to "The Healing Reawakening" by Francis MacNutt, PhD. Dr. MacNutt is a well respected author, lecturer, and founder of Christian Healing Ministries. ( christianhealingmin.org)I highly recommend his thoroughly researched books.Jesus told the apostles to cure the sick. I am suggesting that we should do as He said.

Beth, I am aware of the fact that there were many healings in the early days of the Church (indeed, there are many even now) ... thank you for the reference to MacNutt's book.

What has become clear from your two comments is that you completely collapse healing miracles and the Sacrament of the Sick into one reality ... you act as though they are one and the same.However, the Church distinguishes the two (following St. Paul). The miraculous healings are evidence of charisms of the Holy Spirit, while Anointing of the Sick is a sacrament.

Both the sacrament and the miracles are present in every age of the Church ... but you simply cannot claim that the miracles tell us how and when to administer the sacrament.

In any case, I am glad that you have cited Francis MacNutt ... for my part, I have cited Pope Paul VI, and the Instruction he approved (as well as the Code of Canon Law, and St. Thomas Aquinas [just for good measure]) ...

Let's BOTH cure the sick AND administer Anointing according to the mind of the Church and the nature of the sacrament.

Exposing the sacrament to nullity doesn't do anything to cure the sick, after all.

I appreciate your post. I wonder, however, if you have fully accounted for the phrase "begins to be in danger" from the Code. This seems to open the Sacrament up to a wider application than the tenor of your post, which consistently uses phrases such as "those who are seriously ill," "those who are in danger of death," "Only those who suffer from a grave illness which puts the individual in a real danger of death...."

I fully appreciate this discussion, having seen both sides, and hopefully following the Church's teaching as we understand it/ I suffered a TIA ("mini-stroke") at age 55 with no advance warning. While in the hospital for monitoring and tests, my pastor visited me and administered Annointing. I did not request it, but in his view, my future was very uncertain and unknown; hence I was "seriously sick." In fact, my symptoms cleared upon arrival at the hospital and I am convinced that the physical healing offered by the sacrament was realized in that rapid cessation of symptoms, in that I believe that God can act outside of time.

Two years ago my wife underwent laproscopic surgery to remove her gall bladder. She firmply believed that Annointing was not appropriate, did not ask for it, and did not receive it because the condition and the procedure were not seriously life-threatening.

I think both of these calls were correct, and seem to be in full agreement with the whole point of this discussion about the real Church teaching, and not some popular contemporary social interpretation.

Dan,The reference to "serious illness" and those who are "seriously ill" does not come from the Code of Canon Law, but from the Instruction promulgated by Paul VI.

The words "danger of death" do come from the Code.

The word "serious" could be translated also as "grave" or "dangerous" ...

Certainly, if there is a real doubt, we can give the sacrament (after consultation with a doctor and priest). However, far too often, when there is no doubt at all, the sacrament is given either to those who are not sick at all (but are going in for a simple surgery) or are not seriously sick (by any real definition of the term).

I hope this helps. For the record, I don't think you are splitting hairs, you are quite right to seek clarification regarding such an important issue!Peace to you! +

I really think you should not leave the discussion simply at "no Anointing for surgeries no matter how dangerous" without including "But, by all means make a good Confession and worthily receive the Eucharist!" Whether or not anyone wants to call this reception of the Eucharist "viatecum" is completely unimportant.

In my medical training we were taught that minor surgery could be defined as that which we were to perform on others. Serious surgery was defined as that which was going to be performed on us. ; )One does not have to leave someone who is otherwise relatively healthy and is about to undergo a serious surgical procedure without a kind and pastoral encounter. A prayer with them and for them given with a comforting presence will go a long way to show them that the love of Christ, present in the minister of the Church, is with them as they endure their procedure. The “Pastoral Care of the Sick” book has various prayers which can be more fitting than anointing in many situations. I suspect that the Sacrament of Penance is often neglected to be offered as part of the encounter for both the Sacrament of the Sick and the administration of viaticum in the hospital setting. Those who are truly sick and may be at risk of losing their mental faculties in the near future should not be deprived of the opportunity to receive absolution.-Deacon Steve

When I was pregnant the first time, I had an emergency c-section. All of my subsequent pregnancies have been c-sections. I have received Anointing of the Sick for the preborn babies not necessarily for myself. For myself, I go to confession!

My thinking now is that based on your article I should not be doing this (the Anointing of the sick not the confession!). Am I understanding you correctly? I'm still in my first decade as a Catholic so please bear with me and my elementary understanding of the faith.

Thanks for the clarification Father. As an example, my wife had to have brain surgery to repair several anuerysms. She received Anointing of the Sick before the surgery. I had my Gall Bladder out. I did not receive the Sacrament (I did ask for it because of my mistaken belief and knowledge but see now that it wasn't necessary and am thankful that our Priest did not get to it).

Dear Father,You mentioned non serious surgeries like tonsils....I hemmoraged after my tonsilectomy and needed to go back into surgery. To me that could be serious and was a serious situation. High blood pressure is sometimes a wild card.....causes stroke unexpectedly if and elderly person forgets to take his medication. Does not the power of this Sacrament reach the inner most being of the person? The heart and soul that needs tending and strength to face the cross? How can we pick and choose when only God can read the soul? What will happen to 'healing masses;? I just feel that anything the church (through Jesus Christ) has to offer to strengthen our faith, will, mind, and soul is to be given and used. Many of our so called faithful flock are leaving to explore other faith congregations....could this be part of the reason? How about women who suffer from the turmoil and mental anguish of a past abortion? Don't they deserve this grace and oil to help them heal and forgive themselves....to give them strength and peace? Just some thoughts that this discussion has provoked in me.Thank you and God bless you.Mary

Thank you, Father. As a canon lawyer, I only paid attention to the Code :-). I agree 100% that this Sacrament has been widely abused. Even I, as a healthy 29 year-old, once got in a line for what I thought would be a blessing of some sort and walked away with the oil of the sick on my head and hands. On the other hand, people can "go in" for what is supposed to be minor, commonplace surgery (e.g., gall bladder removal) and it turns into something truly life-threatening. Such happened to my mother not long ago.

Without question, greater discretion should be used in the administration of this Sacrament. I appreciate your efforts to give guidance as to how to go about doing that.

Hello,I do not understand how you take "it is fitting to receive the Anointing of the Sick just prior to a serious operation" to mean that one should not receive Anointing prior to a serious surgery? I understand that you make the distinction between the underlying cause of the surgery and the surgery itself, but as a physician, I have to tell you that we DO see any surgery and anesthesia as potentially life-threatening. I am not sure who you have talked to who told you not. General anesthesia ALWAYS carries the risk of death. Now, that may not mean that people should receive the Anointing, but I find the CCC to read pretty openly there, and that you are the one defining what they say based on the Holy Father's comments, where you again seem to be the one to define what "seriously ill" means and doesn't mean. Even the biblical quote, "Is ANY man sick among you etc" seems pretty wide open to me. I look forward to hearing your response, and appreciate the blog and your insights!

Jenny,Depending on the circumstance, I would think that a pregnancy that required a c-section could qualify as a "serious" condition (i.e. as a serious illness) -- certainly the pregnancy would be extremely dangerous to health without the surgical operation.Therefore, though I am not a doctor, I would think that the condition (independent of the question of the seriousness of the surgery) may warrant the Sacrament of Anointing.

However, I must point out that Anointing of the Sick cannot be for your pre-born children ... for two reasons.1) They are not yet baptized and therefore cannot receive any grace through the sacrament of Anointing.2) Anointing is for those who have committed actual sins (it is a sort of 'second part' to confession) ... as your children had not committed any actual sins, they had no need for the graces of Anointing of the Sick. [in other words, it is a good thing that they cannot receive Anointing; because it means that they are free of actual sin ... and they will be washed of original sin in their baptism]

So, if you are going to receive Anointing before a c-section, be sure of a couple points:1) The Anointing is not for the surgery itself, but for the "serious" complications associated with the pregnancy. [the surgery is a good occasion, but not the actual cause, of Anointing]2) The Anointing is not for your child, but for you.3) If there is a real doubt as to whether the condition is serious enough to warrant Anointing ... the Church instructs us to err on the side of receiving the Sacrament.4) Finally, consultation with both a doctor and a priest can help with this.

I hope that this helps. You obviously have a great desire to learn the faith and a great openness to the Church's teaching authority ... this will most certainly serve you well!

Mary,While (for the most part) Anointing should not be given before a surgery for tonsils, it should most certainly be given in the case of a hemorrhage after the surgery.

I think the most important line in your comment is this: "I just feel that anything the church (through Jesus Christ) has to offer to strengthen our faith, will, mind, and soul is to be given and used."

I completely agree! And the Sacraments should be used according to the mind of the Church, according to the purpose for which Christ instituted them!

Hence, for post-abortative women (as per your example), the proper sacrament is not Anointing (which would do them NO GOOD), but Confession (indeed, multiple confessions, together with counseling).[this is simply one example]

What I have written above is not my own opinion, but the very clear teaching of the Church -- from Canon Law, the Instruction of Paul VI, and (though not quite so directly) from the Catechism of the Catholic Church.We simply must follow the mind of the Church in these matters -- for she reveals to us the will of Christ our Savior.

Anonymous (9:29am),In the future, please use a pseudonym (at least at the end of your comment) -- I ask this both on the main page and also in the comment box itself, just above where you leave your comment.

Regarding your question ... the quote from the Catechism needs to be interpreted in light of the clear teaching of the Church in both Canon Law and the Instruction promulgated by Pius VI. The Catechism is meant for catechesis, not for solving all the questions of theology... [and the Catechism quote does not contradict the other documents, it only speaks more generally and with a specifically catechetical view]

Regarding the danger of anesthesia ... I fear that you have completely missed the whole point of the article.

IT IS NOT ABOUT WHETHER THE SURGERY IS SERIOUS ... the question is whether the illness that leads to the surgery is serious.

IT IS NOT ABOUT DANGER OF DEATH ... it is about SICKNESS (or old age) that puts one in danger of death.

Regarding the biblical passage ... "Is ANY man sick among you etc." ... to that I simply respond, "Is any man SICK among you etc."

Finally, please understand, I do not intend to limit what the Holy Father (and the Church) means by "serious illness" or "danger of death" ... the article isn't even about what counts as "serious"! Rather, the whole point is to say that "serious surgery" is not the same as "serious illness" and therefore is not a cause for Anointing.

I am very open to taking a wide view of what counts as "serious illness" or "old age" ... what I am not open to is the claim that the Sacrament of the Sick can be given to people for surgery or war or the death penalty (i.e. that it can be given to people for any other reason than serious sickness [or old age]).

Put simply ... it is the Sacrament of the Sick, not the "sacrament of those about to undergo surgery" nor the "sacrament of those about to die (i.e. from any cause)".The sacrament is for sick people, and it is given for sickness.Surgery is a good occasion for Anointing, in the sense that (if a person is seriously sick) we had better make sure that they get Anointed before undergoing a life-threatening surgery -- not on account of the surgery itself, but on account of the sickness.

Our Church does an Anointing of the sick the first Saturday of the month and I see most of the members present is anointed by the Priest. I beleive ths reason for this is the Priest tells all that if you are sick from an illness or sick form sin you should be anointed. We are all sick from daily sin. Is this the correct response?

I had a serious blood clot two years ago that was life threatening. I survived but remain on Coumadin blood thinner for the rest of my life. On June 24th, 2011 I had prostate surgery for an enlarged prostate which was necessary so that I could urinate as it had gone to full retention and made it necessary that I wear a catheter for two months awaiting the surgery. The concern with this operation was that I would need to be removed from my blood thinning medication which meant that during the surgery or afterwards I could get another life threatening blood clot. Prior to the surgery I received the Annointing of the Sick sacrament. Did I qualify for that?

Before open-heart surgery my pastor suggested anointment and I agreed.After 3 bypasses the surgeon started to close my chest, when the heart stopped. Shocking was not effective, so he opened me up again and massaged my heart by hand with good results. He then applied a fourth bypass, resulting in 8 hours in surgery instead of the routine 4 and went to ICU in critical condition.Had it not been for the great skill of the surgeon and possibly the anointing, I would not be writing this, 8 years after the fact.

Ken,Based on your description, I do not think that this is a proper use of Anointing of the Sick.In particular, the idea that "we are all sick from daily sin" is being used to justify Anointing is quite troubling.

Anointing of the Sick requires the person to be physically sick -- the physical sickness (and perhaps the physical healing) is the sacramental sign which effects the spiritual healing of the spiritual sickness.

Thus, unless everyone (or most everyone) at that Saturday Mass is "seriously" ill and has "begun to be in danger of death", they should not be receiving Anointing.

Moreover, even for those who are seriously ill (or who have become seriously feeble due to old age), Anointing is to be repeated only upon the significance worsening of the condition.So, if a person receives Anointing once for a serious illness, they should not receive Anointing a second time, until the illness worsens and their health becomes significantly more compromised.[hence, the idea of receiving Anointing once a month (as on a scheduled basis) does not seem to make a lot of sense (at least, not in most cases)]

dcs,It seems that the Apostolic Pardon is not so directly associated with sickness or old age, but is more connected with death itself.

The Handbook of Indulgences (#28) states: "Priests who minister the sacraments to the Christian faithful who are in a life-and-death situation should not neglect to impart to them the apostolic blessing, with its attached indulgence."

So, my thought is that it should be given to a person about to be executed (not months before, but rather close to the time and day of execution -- perhaps even a day or two beforehand, if necessary).

Also, it is to be noted that the Church herself extends the indulgence attached to the Apostolic Pardon to all the faithful who, with the proper dispositions, are unable to receive the blessing from a priest, but who desire this indulgence and have "regularly prayed in some way during their lifetime".So that is great news! +

[likewise, Viaticum would be appropriate, together with a good confession (of course)]

Father,As an RN I agree with anonymous physician that I think you do not have a full understanding of surgical risk and I want to expound on that a little.

There is no surgery that involves general anesthesia and cutting of blood vessels that is not a potentially life threatening surgery, even tonsillectomies to use your example. In medicine, we speak of risk/benefit and most surgeries have a mortality statistic. A low risk of mortality, such as 2%, is a population statistic and not to be confused with it's seriousness for an individual. If you are one of the 2% it's 100% fatal! Very often there is no way to predict who will die, therefore every case must be considered serious.

To use another example you say that in the case of the woman having a C-section, her pregnancy, not the surgery is sufficient reason to receive the sacrament. Not really true if you use the same logic you've used elsewhere. Pregnancy, first of all, is not an illness although complications can arise. But, it is the danger of the C-section, not her pregnancy per se, that makes it serious and puts her in possible danger of death from hemmorhage. To complicate matters medically even further, many repeat C-sections are not even absolute requirements, but are precautionary choices after weighing risks/benefits. So potentially we can have a woman electively choosing to undergo a life endangering surgery for a condition that is not an illness.

Rationally speaking any illness that requires a dangerous surgery IS a dangerous illness - the neccessity of the surgical cure makes it so! I think your underlying point about abuse of the sacrament is good to make. But I think splitting such subjective hairs about serious illness vs serious surgery has rather muddied things more than clarified them.

momor,First, you speak about how any surgery which involved anesthesia is a dangerous surgery ... this is irrelevant to the question. The Church is very clear: Only serious illness or old-age can be cause for Anointing of the Sick.[example: Lethal injection, which is 100% fatal, is not cause for Anointing -- until, I suppose, after the poison has been given]

Second, you state, "Rationally speaking any illness that requires a dangerous surgery IS a dangerous illness" -- fine and good, but you seem to define "dangerous surgery" as any surgery using general anesthesia ...I know of cases where people have used general anesthesia to remove a tooth ... hardly a "serious illness"!

In fact, it is quite clear that general anesthesia is not really thought by the medical world to necessarily make a surgery a "serious surgery". It is simply not that case that such surgeries are only done when the illness is so serious as to put the individual in danger of death.Remove of tonsils (for example) is sometimes done with general anesthesia (at least, it used to be this way) ... this hardly a "serious illness".

Let me be clear: I am not so much debating what constitutes serious surgery ... what I am talking about is the fact that the surgery cannot be the cause of the Anointing, it has to be a "serious illness" which "seriously impairs health" and which puts the individual "in danger of death."It is the sacrament of the SICK, and sickness (not surgery) is the cause of Anointing.

In any case, tomorrow an article will be posted on what constitutes a "serious illness".

Correction:An RN has pointed out to me that "general anesthesia" is a more specific process than most non-medical persons realize.Apparently, "general anesthesia" is different from anesthesia which is administered through an IV and which puts the person to sleep. By "general anesthesia", the medical world refers to the use of a breathing tube/respirator etc.

Now, I had not said anything at all about "general anesthesia" ... until my comment on July 12 6:59pm.Obviously, what most non-medical persons call "anesthesia" is used quite frequently -- however, medical persons call this "IV sedation" and it is used frequently (for very minor surgeries).

In any case, the point of the article is that no anesthesia, no matter how dangerous, can be the cause of Anointing of the Sick. It is the sickness (or age) which is the cause of the sacrament, and the surgery is only the occasion.

If there is a serious illness -- and this could (in certain circumstances) include broken bones and other such maladies -- or if the person is feeble and in danger of death due to old age, then the sacrament of Anointing should be given.

If the illness is not such that the individual is in danger of death and his health is not "seriously impaired" -- then Anointing is not appropriate, even if he is going into surgery (and even if this surgery involves sedation).

Reading the comments of the doctor and nurse, who make the argument that all surgeries contain the risk of death, made me think that this cannot be the basis for when the Sacrament is administered, as Father Reginaldus has repeatedly stated.

People are at risk of death when they fly on an airplane, aren't they? We are in even more risk of death when we get into an automobile. Should we receive Anointing of the Sick every time we get into a car? Of course not.

Father made it quite clear, I thought, in his article that it is the reason for the surgery that determines whether the Sacrament is necessary. Not the risk involved.

In fact, Father begins with the reason for the Sacrament, which is spiritual healing. I assume this is because despair can set in, giving the Enemy a chance to tempt one into blaspheming the Holy Spirit. I will have to look that up in CCC.

Thank you, Father, for an excellent article. I will now read the others.

I volunteer in a hospital where Annointing is offered on a regular basis (once a month and on the feast days of saints whose lives involved treating sick people).

I know that I for several years treated Anointing as a "blessing" that could be received as often as I wanted. Actually, it is more like the Sacrament of Confirmation in that it may be only received once (per incident of a serious illness).

After reading Father's post, and aection 1515 of the CCC, I see his point.

1515; "If during the same illness the person's condition becomes more serious, the sacrament may be repeated."

Thus, long term high blood pressure and heart problems that are stabilized with medication would not be considered a justification for repeating the sacrament unless they greatly worsened.

I am a Byzantine Catholic priest and I am surprised that you are not aware that in the Byzantine Church we administer the Sacrament of Anointing the Sick, Holy Unction, on every Great Wednesday of Holy Week, to every Catholic, spiritually disposed, who presents himself for the Sacrament. It has and is an ancient tradition of the Eastern Catholic Church. Our theologies and canons differ from the Latin Church on this Sacrament as they do for the Sacrament of Marriage.God Bless you and your readers. +In Christ

Rev. Father Kolitsos,I'm well aware of the practice in the East ... I suspect that you are ignorant of your own Canon Law ... which states:

----------------Canon 7371. By the sacramental anointing of the sick with prayers of a priest, the Christian faithful who are gravely ill and sincerely contrite receive grace, by which, strengthened by the hope of eternal reward and absolved from sins, they are disposed to correct their lives and are helped in patiently enduring their infirmity and suffering.

and Canon 738The Christian faithful freely receive anointing of the sick whenever they are gravely ill; pastors of souls and persons who are close to the sick are to see to it that they are supported by this sacrament at an opportune time.

---------------

Your own canons require that the individual be "gravely ill".Further, they must be above the age of reason so as to be "sincerely contrite".

I am having surgery to determine if the symptoms I am experiencing are cancer. If the surgery determines that it is cancer, I would have had a serious illness before the surgery. But I would not have known I had the serious illness at the time of surgery. Would anointing be appropriate before the surgery? I had surgery a few years ago to remove a mass in my abdomen. At the time of surgery, it was not known if it was cancer or not. My priest recommended the Anointing of the Sick. It turns out the mass was benign, but an artery was severed during the surgery, resulting in near death and a long ICU stay. I was so grateful I had received the sacrament before the surgery. But was it appropriate under what I am understanding above? I hope you do answers my questions, but please do with some pastoral kindness. Admittedly, I am very saddened to read the hostile tone in many of your responses above. Elizabeth

Elizabeth,In cases of real doubt about the seriousness of an illness, when it seems probable or at least very possible that an illness could be life threatening, anointing should be given. However, it is not given on account of a surgery, but because there is real reason to think the illness has put a man into danger of death.

Setting aside the case from the past, I will simply state that you must consider whether or not, right now with the information you currently have, you have reason to believe you have cancer. If yes, it is time for anointing. If not, then it is not yet time.

As to the tone of my comments -- I am more concerned to write clearly and concisely than to make people feel good. Yet, I do care very much for all who ask questions. +

Is it not true that both the clergy and the lay faithful of the Eastern Catholic Churches and the Eastern Orthodox Churches have taught for nearly 2,000 years that the Sacrament of the Anointing of the Sick is for the healing of entire human person, body, mind, and spirit?

While Canon 737 and Canon 738 of the Eastern Code of Canon Law refer to "grave illness", do you believe that Eastern Bishops & Priests are wrong in administering the Sacrament of the Anointing of the Sick to those who have serious psychological illnesses, emotional illnesses, or spiritual illnesses, rather than being restricted to bodily illnesses?

If the theology of the sacraments is understood differently in other cases between the East and the West, could it not rightly be understood differently in this case as well? For example, in the Divine Liturgy in the Eastern Churches, transubstantiation is not understood to take place when the Priest says Christ's words of institution as in the celebration of the Latin Rite Mass, but rather when the Priest says the epiclesis.

Finally, your comment to Fr. Andrew, the Byzantine Catholic Priest above, reads in a very disrespectful tone. Why would you treat a Brother Priest with disrespect, Father Ryan?

Constantine, correct, I am saying that the sacrament is invalid if the person has not begun to be in danger of death. Further, I affirm as a matter of faith that transubstantiation must be held, and that this occurs by the power of the words of consecration. Further, the best in the eastern tradition is in harmony with the west. Finally, it is no disrespect to tell a brother priest to read canon law. +

Just to clarify, I meant in to way to imply that transubstantiation does not take place in the Divine Liturgy of St. John Chrysostom or any of the other Eastern Divine Liturgies but rather that the Eastern Churches teach that transubstantiation takes place at the point of the prayer of Epiclesis rather than at Christ's words "Take eat...", which precede the Epiclesis. As transubstantiation is a matter of faith I honestly don't know any Eastern Catholics who would even attempt to deny transubstantiation. I don't understand why both the Latin and the Eastern teachings on the Sacred Liturgy could not both be correct while remaining distinct in the different Rites of the Church.

What about the differing theological understanding of the Sacrament of Matrimony in the East and the West that Fr. Andrew mentioned above? In CCC 1623 it states that in the Eastern Churches "...the priests (bishops or presbyters) are witnesses to the mutual consent given by the spouses, but for the validity of the sacrament their blessing is also necessary." Would you hold that the Eastern Theology is not legitimate because we require blessing of the priest but in the Latin Rite the spouses confer the Sacrament of Marriage upon one another without the Priestly blessing for validity? I think that both of these Sacramental Theologies are a rich and beautiful example of what the Eastern tradition and Western tradition have to offer the Church.

Fr. Ryan, with no disrespect to you or to your Priesthood, while the action of telling a brother priest to read canon law may not be disrespectful in it's own right, your words: "... I suspect that you are ignorant of your own Canon Law ...", could certainly be received in a disrespectful, demeaning, & hurtful manner by a brother priest. Likewise, the readers of your blog may perceive your words in this manner. I found it to be disrespectful and demeaning myself, Fr. Ryan, as the son of Fr. Andrew, your brother priest.

Fr. Andrew recently died, so I would appreciate your prayers for his blessed repose with Our Lord Jesus Christ, the Most Blessed Virgin Mary, and the Saints.

Αἰωνία ἡ μνήμη! Eternal Memory! Αἰωνία ἡ μνήμη!

With the saints, oh Christ, give rest to the soul of your servant, Andrew, the priest, where there is no pain nor sorrow nor suffering, but life everlasting.

Comstantine, I thought my response wa proper considering Fr Andrew professed to be "surprised" that I "do not know" the easter practice - that is an offensive way of speaking. In any case, the eastern law is what it is -- again in the case of matrimony stating that the priest is not the minister but a witness. Your problem is with your own law.Btw, you should know that the latin church does require the priest's reception of the vows for validity in catholic marriages.

Finally, though it is a red herring, I will simply state that, if a man is really a priest (and the eastern priests are), then he says the words "this is..." Over bread and wine he effects transubstantiation. In any rite or form or even outside any rite. That is what the power of the words means.

I am sorry to hear of your father's death - he will be in my prayers. +